The head of the Health Service Executive has said that Irish laboratories will have the capacity to carry out 4,500 Covid-19 tests per day, but that this will be dependent on the availability of the testing reagent.

Paul Reid said that as well as the National Virus Reference Laboratory, 18 hospitals are now testing, and other laboratories, like one for the Department of Agriculture and Enfer, will also add to capacity from the end of next week.

He said labs had only been carrying out between 2,000 and 2,500 tests, but that late last week testing had been constrained to 1,500 tests per day.

The results from the first swabs that were sent off to Germany to be tested last week arrived back on Friday.

Mr Reid said that that German laboratory is now completing 2,000 tests per day for Ireland but that the HSE is "still looking at other EU solutions as we continue to source the reagent supply".

He said that the supply of reagent, the substance needed for the analysis, is a "very significant world wide challenge" and that there is competition to secure a supply.

The HSE is now in ongoing negotiations with firms in Ireland about supplying this critical part of the testing process.

Mr Reid said they are making "some progress" with some firms and that discussions will continue.

A supply of reagent has been secured from "other international markets" and Mr Reid said they would go through a risk assessment and quality testing at the end of next week.

Mr Reid was addressing a briefing this morning as concerns continue to be raised about the suitability of Personal Protective Equipment (PPE )for dealing with patients with the coronavirus.

65% of the PPE that arrived in Ireland from China last week does meet the required specification for use here.

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Mr Reid said that the first batch that arrived is just 10% of the order. Of this, he said the PPE has been divided into three categories. 

The first category includes coveralls, gowns, goggles and face-shields that have been identified as suitable for use, accounting for 65% of the total order. 

A further 15% of the order has been classified as "acceptable for healthcare worker use if the preferred product is not available". 

However, Mr Reid said that 20% of the order that arrived here does not meet the requirements for general healthcare use. 

He said that from this batch, the HSE will be using this material for other purposes, and this could include isolation units. 

He added that a specific issue relates to masks that do not meet the requirements for specific respiratory masks but may be used for other purposes. 

Mr Reid said that the HSE does not want any further delivery of these items in future orders and that it has been in discussions with the supplier about this.

Around 80% of cases of Covid-19 will be a mild to moderate illness, close to 14% have severe disease and around 6% are critical. 

Generally, you need to be 15 minutes or more in the vicinity of an infected person, within 1-2 metres, to be considered at-risk or a close contact.

But there are higher risk settings, where transmission is possible in a shorter time interval, where health staff are dealing directly with known or suspected cases.

5,000 extra beds available

The HSE has signed an agreement with all private hospital groups to give it full use of private hospitals during the Covid-19 crisis.  

There are now 5,000 extra beds available between public and private, 1,100 isolation beds at Citywest, and a further 450 overflow acute beds are currently being constructed at the Dublin hotel. 

Mr Reid said another 1,200 isolation will also be put in place around the country and work also been done to increase the number of ventilators available here. 

We already have 1,100 of these between public and private hospitals, Mr Reid added.

The CEO said that 25 new ventilators have already arrived and been dispatched to St James's and the Mater hospitals, and that a further 225 will arrive this week. A total of 1,300 ventilators will be delivered by the middle of April, he commented.

Mr Reid said that ICU capacity is "our biggest challenge" during this crisis. 

The health service will be utilising ICU beds, high dependency beds, theatre and post operation beds to give a capacity of "over 800 equivalent of critical care beds".

Training up staff to support this increased ICU capacity will also be a challenge, he said. 

Meanwhile, Chief Operations Officer of the HSE Anne O'Connor said 37,000 tests for Covid-19 have been completed and their results returned.

Also speaking at the press briefing, she said we now have 50 community testing sites, although they have not been operating at capacity due to the challenges with the laboratory testing. 

Ms O'Connor said the testing rate in Ireland is "still very high, internationally" and placed us at the same level as Hubei province in China, where the coronavirus originated. 

The first community assessment hubs will be open and accepting patients around the country during the week. The hubs will provide "enhanced support" for people who have tested positive for the virus. 

Ms O'Connor said there will be 12-15 hubs in place by the end of the week and they will operate out of Primary Care Centres, seven days a week from 8am to 8pm. 

The assessment hubs are for people who are symptomatic, and who are becoming worse and for whom GPs feel they may need a clinical intervention. 

Ms O'Connor said this approach will maximise the number of people who can be cared for at home, and reduce the number of people being admitted to hospitals. 

The first hubs will be located in Letterkenny, Galway, Limerick, Cork, Wicklow, Drogheda and Athlone. 

The number of people attending emergency departments is now down by more than 50% on this time last year, while hospital admissions from emergency departments has dropped by 41% year on year. 

Ms O'Connor said that this is a "concerning story" of people not attending when they need urgent care and urged people who need emergency care to still attend. 

As of 8am this morning, there were 794 people with Covid-19 being treated in acute hospitals; 142 of these are being treated in ICU. 

The HSE's lead on infection prevention and control has said that health staff have had to do things they would not normally, like reuse eye protection that was only intended for single use. 

Martin Cormican has carried out an assessment of the batch of PPE that arrived here from China last week. 

Giving examples of items that have been deemed suitable for use here, Dr Cormican said there is an "issue about familiarity" with some of these products. 

One item that met specifications is a coverall suit.

Dr Cormican said that while the Irish healthcare system always favoured the use of gowns, the coverall does meet the required specifications.

But he said "we will need to do work on training" for the use of the product.

Two different categories of masks, respirator and medical masks, as well as eye protection were also deemed suitable.

Dr Cormican said there is also a "large supply of gloves that are suitable for use". He gave an example of another coverall suit, which was not as hard wearing or durable as the first.

Dr Cormican said this was suitable for use, if the preferred product was not available and said a product like this was "useful to have in reserve".

Other masks that were not suitable for general healthcare use were ones that used ear loops instead of ties.

Dr Cormican said these should not be used by healthcare professionals, but could not be used by a person who was waiting to be assessed.